Diagnosis and Treatment of the Lower Extremities: Nonoperative Orthopedic Medicine and Manual Therapy.

Diagnosis and Treatment of the Lower Extremities is the second book in a series describing nonoperative orthopedic approaches to the management of common orthopedic disorders encountered by physicians and physical therapists. The authors present techniques for identifying and treating the exact structure responsible for pain or impaired movement in the lower extremity.

The book contains three parts. Part I covers the hip, part II covers the knee, and part III covers the ankle and foot. Each part has a specific chapter devoted to functional anatomy, surface anatomy, examination, pathology, treatment techniques, and peripheral compression neuropathies. In addition, each section ends with review questions and answers, current references, and an extensive recommended reading list. There are six comprehensive appendixes at the end of the text, five of which provide algorithms for diagnosing and treating the lower extremity in general or by specific region.

The chapters on the functional and surface anatomy of the hip, knee, and ankle lay the foundation for the principal part of the book: examination and treatment. The authors' primary examination approach is the application of selective tension to each structure that could be responsible for the symptom. The information obtained from this examination is then correlated with the patient's history and the practitioner's knowledge of functional anatomy to diagnose the lesion site accurately.

The chapters on treatment techniques mention site injections, transverse friction, and stretching and strengthening exercises; however, these chapters primary focus on manipulation and mobilization techniques. Despite the book's extensive coverage of these techniques, the reader at least should know basic manual therapy skills or should take a hands-on course to learn these skills in order to use the movements illustrated in the book.

In addition, several problems concerning the illustrations, a vital part of the book, make the text difficult to follow at times. The numerous illustrations are sometimes misleading or difficult to find. For example, the reader may be referred to an illustration in another chapter, but no page or illustration number is given. The illustration may also be numbered incorrectly. In other cases, the position of the therapist in the illustration differs from the position described in the text.

Despite these problems, this book will be of interest to physical therapists who practice manipulation and mobilization techniques on a regular basis.

Ms Ingles is Director of Physical Therapy at the Sullivan County Board of Cooperative Educational Services and specializes in school-based physical therapy. She also has a Private Practice that provides physical therapy to infants at risk and geriatric patients.